The results of screening more than 23,000 serum samples from persons belonging to risk groups, as well as those not belonging to such groups, in Moscow, Vilnius and Klaipeda are presented. Screening was carried out with the use of an assay system manufactured by the Scientific and Industrial Amalgamation "Antigen" (USSR). In this screening 3 HIV carriers were detected; of these, 2 were foreign students from two African countries.
In order to assess the acceptability of voluntary population screening for antibodies against human immunodeficiency virus (HIV), a random sample of 300 Danish men, aged 20-49 years, were sent a self-administered questionnaire. Among nonrespondents, recruitment attempts were repeated three times with intervals of 8-10 days. In total, 76.7% responded. Two hundred men (87.0% of the respondents) would accept an offer to be tested in an anti-HIV screening programme. Among respondents, 72.9% agreed to identify themselves to the researchers, 22.1% preferred to be tested under a code number known only by the participant himself, and 5% wanted the test information to be completely anonymous. Among the 30 men refusing HIV testing, 40% reported they were not concerned about AIDS, 16.7% expressed concern with confidentiality problems, and another 16.7% had been tested already and for this reason declined to participate. Previous reports have indicated high seroprevalences among nonrespondents and raised prevalences of behavior at high risk for HIV infection among persons who do themselves take the initiative to be tested or who decline to be tested because they worry about confidentiality. Low respondency and the associated disproportional loss of subjects at high risk of HIV infection may bias HIV seroprevalence estimates based on population probability sampling, especially in areas with low HIV infection prevalence. Because of these biases, voluntary population screening is likely to give only lower bound estimates of HIV seroprevalence. So, this technique should only be used in combination with other surveillance approaches.
Given the increasing endemicity of human immunodeficiency virus (HIV), the agent implicated in the causation of acquired immune deficiency syndrome (AIDS), in numerous sizeable subgroups of society, hospitals can expect increasing exposure to the legal implications presented by patients with AIDS. This paper reviews the duty of care owed by hospitals, both directly, through contractual obligations, and indirectly, through the acts of their employees and private contractors, to patients with AIDS, other patients and the public. Owing to the absence of case law directly related to AIDS or to HIV antibody reactivity, inferences were drawn from precedents set with other infectious diseases. Recommendations are made in the areas of confidentiality, informed consent, standards of care and vicarious liability.
Cites: Leg Med Q. 1979;3(2):93-10010245513
Cites: Science. 1986 May 9;232(4751):6973008335
Cites: Ann Intern Med. 1983 Mar;98(3):290-36299154
Cites: Science. 1983 May 20;220(4599):868-716189183
More than 80,000 blood samples are annually transported to the Lutsk diagnostic center for assessment of antibodies to HIV. A polystyrol container for 50 vials is used for transportation of the blood samples for these purpose. The advantages of this way of transportation are discussed.
Blood sera, originating four regions of Russia and Byelorussia and previously tested for the content of antibodies to HIV-1 proteins, were studied in the enzyme immunoassay on the basis of recombinant sequences gp160, as well as on the basis of oligopeptides corresponding to sequences V3 of six HIV-1 strains. The possibility of using sequences gp160, contained in fusion polypeptides synthesized in Escherichia coli cells, for the detection of antibodies in laboratory research was shown. Differences in the reactivity of the sera under study with respect to fragments gp160 correlated with the geographical origin of these sera: similarity between the serum samples from Elista and Rostov and their difference from serum samples collected in other regions were shown.
The anonymous survey of the population for the presence of human immunodeficiency virus (HIV) carried out in Moscow in 1987 revealed 4 seropositive persons among 10, 117 persons subjected to examination. These 4 persons belonged to typical risk groups with respect to the acquired immunodeficiency syndrome (AIDS). The questioning of the persons coming for examination made it possible to find out that a large percentage of them really had a risk of contacting HIV infection; besides, a considerable proportion of the visitors proved to have signs of AIDS phobia.
The data on the study of the spread of HIV infection among injecting drug users in St. Petersburg, carried out by the method of the random testing of blood remaining in used syringes, are presented. Injecting drug users visiting buses working in accordance with the program "Buses for Assistance to Drug Addicts" were chosen as a study group. The exchange of syringes was one of the elements of this program. The work was carried out in two areas with a high concentration of drug users. The eluates from syringes used by 300 persons were studied. The average rate of the spread of HIV in the cohort under study was 12%. The results were indicative of a high degree of the spread of HIV among injecting drug users in St. Petersburg. Epidemiological patrol surveillance proved to be an effective method for the evaluation of the epidemiological situation in a highly inaccessible group of the population.
For the first time a nosocomial focus of HIV infection was established. Out of 83,000 inhabitants of the Kalmyck ASSR who underwent planned examination in the course of epidemiological investigation, 65 cases of HIV infection were detected and all of them were traced to the focus of hospital infection (56 children and 9 adults: 1 man and 8 women; of these, 7 women contacted the infection from their infected children in the process of breast feeding). The children were infected during their stay in two hospitals of Elista where they received multiple intravenous and intramuscular injections. The infection spread from the infant department of the regional pediatric hospital to 4 more departments and to the infectious diseases hospital. Transmission of this infection was maintained for several months by the use of nonsterile syringes in parenteral manipulations.